title: Effects of electroacupuncture on stress-related symptoms in medical students: a randomised placebo-controlled study.
abstract: OBJECTIVE
  To assess the effects of electroacupuncture (EA) on relieving stress-related symptoms-sleep disorders, anxiety, depression and burnout-in medical students.
  
  
  METHODS
  Eighty-two students were randomised into an EA treatment group (n=30), a sham TENS group (n=18) and an untreated control group (n=34). EA was applied at a continuous frequency of 2 Hz to the limbs, face, ears and scalp for 20 min once a week, over 6-8 weeks. Sham transcutaneous electrical nerve stimulation (TENS) was performed on similar sites for the same number of times in each session and for the same length of time. Outcome measurements included a comparison of the indices obtained by different self-applied questionnaires before and after treatment. The surveys used were the Mini-Sleep Questionnaire (MSQ), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), the Beck Depression and Anxiety Inventories (BDI and BAI) and the Maslach Burnout Inventory-Student Survey (MBI-SS), in addition to the Quality of Life Questionnaire-abbreviated version (WHOQOL-bref).
  
  
  RESULTS
  EA significantly improved scores on the MSQ, PSQI, BDI and the cynicism and academic efficacy (AE) dimensions of the MBI-SS in relation to the control. Sleep quality (MSQ) improved from 36.9 (SD 7.6) to 25.0 (5.7) with EA, 37.6 (6.0) to 32.1 (6.9) with sham TENS, and 36.5 (5.9) to 33.6 (6.7) in the controls (p=0.0000). Compared with the sham TENS group, EA significantly reduced scores on the PSQI. Score improvements in the sham TENS group in relation to control group were significant in the MSQ, BDI and AE. In the EA group, the number of students with better scores after intervention was significantly higher for the MSQ, PSQI, ESS and BAI. This only occurred for the MSQ in the sham TENS group and for the MSQ and ESS in the control group.
  
  
  CONCLUSIONS
  EA significantly reduced stress-related mental symptoms. The improvement obtained by sham TENS compared with the control group confirmed the presence of a placebo effect resulting from the treatment ritual.
authors.affiliation: Community Health Institute, Fluminense Federal University, , Niteroi, Rio de Janeiro, Brazil.
authors.forename: Marcio
authors.initials: M
authors.lastname: Dias
authors.forename: Guillermo Coca
authors.initials: GC
authors.lastname: Vellarde
authors.forename: Beni
authors.initials: B
authors.lastname: Olej
authors.forename: Ana Emília
authors.initials: AE
authors.lastname: Teófilo Salgado
authors.forename: Ighor
authors.initials: I
authors.lastname: de Barros Rezende
mesh_terms: D015669:Acupuncture Points; D001938:Brazil; D015671:Electroacupuncture; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D012890:Sleep; D013315:Stress, Psychological / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: SLEEP MEDICINE